妇科腹腔镜术后患者排气时间影响因素的临床研究  

Clinical study on the influencing factors of exhaust time in patients undergoing gynecological laparoscopic surgery

作　　者：高宇[1] 魏薇[1] 刘冰[1] 贾朝霞[2] 吴维佳 沈佩佩 GAO Yu;WEI Wei;LIU Bing(Department of Gynecology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China;不详)

机构地区：[1]首都医科大学附属北京妇产医院妇科,北京100026 [2]首都医科大学附属北京妇产医院群体信息科,北京100026

出　　处：《中国医学装备》2020年第8期109-112,共4页China Medical Equipment

基　　金：首都医科大学附属北京妇产医院青年基金专项课题(FCYYQN-201701)“妇科腹腔镜术后患者排气时间影响因素分析临床研究”。

摘　　要：目的:研究影响妇科腹腔镜患者术后24 h排气的相关因素。方法:选取206例行腹腔镜手术治疗的妇科患者,根据术后24 h内是否排气将其分为≤24 h排气组(142例)和>24 h排气组(64例)。于术前、术中及术后收集患者术前焦虑评分(SAS)、手术持续时间等术中情况,以及使用镇痛泵情况、留置尿管时间、首次排气时间、首次下床时间、首次进食时间、术后发热天数(>37.5℃)、术后疼痛评分数字量表(NRS)、术后血钾和补钾情况的相关资料,采用单因素和Logistic回归进行分析。结果:≤24 h排气组和>24 h排气组患者术后排气时间受手术持续时间、出血量、CO2气腹量、下床时间、进食时间、留置尿管时间和焦虑评分因素影响,两组比较差异有统计学意义(t=-3.138,t=-2.274,t=-2.590,t=-6.127,t=-4.096,t=-5.397,t=-2.434;P<0.05);受肠粘连程度和是否使用镇痛泵因素影响,两组比较差异有统计学意义(x^2=10.547,x^2=12.538;P<0.05)。术后是否使用镇痛泵、下床时间和焦虑总分高为术后24 h排气的相关因素(OR=1.115,OR=1.001,OR=1.067;P<0.05)。结论:术后使用镇痛泵、焦虑程度严重的患者,术后排气相对较晚,而首次下床时间越早排气时间越早。应针对影响患者术后排气时间的因素中术后镇痛、焦虑及首次下床时间进行干预,促使患者术后早期排气,减少并发症。Objective: To analyze and study the relative factors that affected the exhaust of patients who underwent gynecological laparoscopy postoperative 24 hours. Methods: 206 gynecological patients who underwent laparoscopic surgery were selected and were divided into group A(the exhaust time ≤24 h, 142 cases) and group B(the exhaust time >24 h, 64 cases) according to whether they had exhausted within postoperative 24 h. The preoperative anxiety score(SAS), the duration of the operation and other intraoperative conditions were collected during and after the operation, as well as the use of analgesic pumps, indwelling catheter time, the first time of exhaust time, the first time out of bed time, the first feeding time, postoperative fever days(>37.5 ℃), numerical rating scales(NRS) of postoperative pain score, the concentration of postoperative blood potassium and potassium supplementation were collected, and then, these data were further analyzed by univariate and logistic regression. Results: The postoperative exhaust times of patients in group A and group B were affected by the duration of operation, bleeding volume, CO2 pneumoperitoneum, the time out of bed, the time to feeding, the time to indwelling catheter, and anxiety score, and the difference of them between the two groups were statistically significant(t=-3.138, t=-2.274, t=-2.590, t=-6.127, t=-4.096, t=-5.397, t=-2.434, P<0.05). And the differences of the effects of the degree of intestinal adhesion, and whether using analgesic pump between the two groups were statistically significant(x^2=10.547, x^2=12.538, P<0.05). The relative factors of exhaust postoperative 24 h included whether using analgesic pump, the time out bed and the highly total scores of anxiety post operation(OR=1.115, OR=1.001, OR=1.067, P<0.05). Conclusion: Patients who use postoperative analgesia pump and have severe anxiety have relatively late postoperative exhaust. The earlier first time out of bed has earlier exhaust time. Intervention should be aimed at these factors included post

关 键 词：妇科 腹腔镜 排气 影响因素 

分 类 号：R616.5[医药卫生—外科学]